It ’ s Anti-Nike Time
I know everyone is tired of coronavirus and all the restrictions its placed on our lives. And I know everyone is getting excited about those restrictions being lessened at last. But I have an important message for my little corner of the world (patients, family, and friends): It’s Anti-Nike time. JUST DON’T DO IT!Just because restaurants are opening back up for indoor dining, DON’T DO IT! Just because gatherings are now sanctioned, DON’T DO IT! Movies, museums, concerts, communal worship, all kinds of normal activities we’ve dearly missed over the last six months are now opening back up again....
Source: Musings of a Dinosaur - September 13, 2020 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
My take on the Coronavirus-19 Outbreak
The following represent MY BELIEFS, albeit as a board-certified (and re-certified x 4) family physician with over 30 years experience, about the novel Coronavirus and Covid-19 disease, based upon basic principles of epidemiology and currently available information. First: I believe that Cov-19 is ALREADY PRESENT in the community. There is currently no way to determine its true prevalance, partially due to inadequate testing, but also because of the nature of the virus (variable disease severity ranging from inapparent infection to fatal disease, and high level of contagion.) What this means is that since anyone could be in...
Source: Musings of a Dinosaur - March 7, 2020 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
The Calm Before Tomorrow
Background: DinoDaughter gave me a book for the holidays called Just Write One Thing Today containing 365 writing prompts. The post title above is Prompt #93, and it’s my reflections on a song written by that same daughter. The lyrics of the song are below, with my musings indented.
Musings on
A Late Night Lullaby
by Joanna Hulse
When the night comes, and the moon glows white;
The sun is long gone and the night is well underway. The clock is ticking, and I have to get to sleep. Why do I lie here staring at the ceiling? Is it the light of the full moon keeping me awake?
Be at peace now, things will be alright.
But w...
Source: Musings of a Dinosaur - April 9, 2018 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
The Rules Have Not Changed
In the wake of the recent flood of allegations of sexual harrasment against so many men in so many different positions of power, the refrain has begun, “The rules have changed.” Frivolous concerns about office holiday parties threaten to trivialize the remarkable transformation of women finally being believed, and men finally beginning to be held accountable for their actions.
The rules have not changed. What has changed is that, at long last, there are now real consequences for breaking the rules. Jobs lost, reputations shredded; punishment for the perpetrators instead of the victims for a change. We havenR...
Source: Musings of a Dinosaur - December 20, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Politics Source Type: blogs
Not Me; But Standing with #MeToo
There’s been a recent social media campaign in the wake of the dreadful revelations about ongoing long term sexual harassment and abuse specifically by media mogul Harvey Weinstein. Posting the hashtag #metoo on Facebook and other social media sites is supposed to call attention to the ubiquity of the problem by showing how many women have experienced this outrageous behavior, and how it’s affected their lives.
As a rule, I tend not to participate in these kinds of things, mainly because I’m not on Facebook or any social media all that much. But in this case, it is also because this is not something I hav...
Source: Musings of a Dinosaur - October 19, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Politics Source Type: blogs
Medical Marijuana is a Scam, with which I Want No Part
People keep asking me what I think about Medical Marijana. Does it really work? Am I willing to prescribe it?
Here’s what I think:
Given that there is no reliable medical evidence of efficacy for marijuana for any condition at this time, I’m gonna say no, it doesn’t work.
Do people who smoke or otherwise consume it feel better? Sure. Getting high feels good, at least to most people. That’s why it’s called “getting high.” But so does a massage or getting your hair done, or eating fresh bread (or baking it.) Or sipping a fine wine, or eating chocolate, or watching a magnificent sunse...
Source: Musings of a Dinosaur - October 18, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Urgent Care Follies
What is it with antibiotics and steroids for upper respiratory infections at Urgent Care these days?
Over-prescribing of antibiotics has been a problem ever since the recognition that uncomplicated upper respiratory infections were almost always viral and would resolve on their own. I like to call the Z-pak (a pre-packaged 5-day course of azithromycin, a macrolide antibiotic) a “Placebo Antibiotic.” It doesn’t help a viral infection, but has relatively few side effects, and the accomplishment of making the patient feel like he’s gotten something for his handsome $15.00 co-pay. Not optimal treatment ...
Source: Musings of a Dinosaur - May 26, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
The Saddest Encounter
I had an upsetting encounter the other day with a 22-year-old woman of color, who mentioned (secondary to the purpose of the visit) that she was pretty sure she had breast cancer.
Why did she think that?
She’d found a lump in her breast.
(Somewhat unusually for the specific setting, she let me do a breast exam. All I felt was a small area of lumpy breast tissue, possibly a fibroadenoma at worst. Of course I would recommend ultrasound and possibly excision, but I wasn’t acting in the capacity of her primary care physician.)
Had she seen a doctor about it?
No.
Why not?
The answer that sent my jaw to the floor:
Ca...
Source: Musings of a Dinosaur - April 18, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Popping Pus
Warning: graphic descriptions ahead. Continue in temporal and/or physical proximity to food and drink at your own risk.
Everyone has their abscess story. Tales of pressurized pockets of pus abound. Trust me: however far-fetched they may seem…they’re not. I had one such experience last week in which a man came to me with a painful red swollen lump on his back. It was about 2 inches in diameter, angry and fluctuant (softened) and ready to be drained, which he pleaded with me to do. So I did.
Although this is typically one of the more painful procedures I can inflict on someone, he did great. Possibly his status a...
Source: Musings of a Dinosaur - March 23, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
The Alt-Right and Alt-Med
I’ve suddenly come to realize that a rising political group, the so-called “Alt-Right” (basically nothing more than “…white supremacists who have repackaged the hate and served it up in a more palatable form for human consumption…“) and much of the “Alt Med” movement (including purveyors and proponents of alternative, complementary, integrative, functional, holistic, and assorted other terms for quackery through the years) have a lot in common.
Both operate in fact-free zones. Reality doesn’t seem to matter to either of them. Immigrants are objectively not streami...
Source: Musings of a Dinosaur - February 21, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Positioning for the Future
As you may have heard, the United States has a new president. From where I sit, things do not bode well for me — that is to say my patients — over the next few years. In addition to the virtual certainty of massive changes in health insurance, I fear a significant overall economic downturn similar to the last time a Republican held office. Until the outgoing president managed to turn around the Great Recession, my income tanked. In fact, it’s only now beginning to come back to where it was seven years ago. Talk about nipping it in the bud!
As I say, though, this is more about my patients than about me per...
Source: Musings of a Dinosaur - January 24, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Why We Do It
Medicine is a business. Of course we have bills to pay to keep the lights on and the phones running. No, as a rule, doctors are not starving. But if money were what we were out for, we sure wouldn’t have opted for seven (or more) grueling years of training followed by the 24/7 call of solo private practice. No; we’re in it for our patients. Aside from the still small voice that tells us when we’ve done well, there are those wonderful times when we get to hear our patients say it explicitly.
A recent email:
…I just wanted you to know that both the care and kindness you provided to me throughout my li...
Source: Musings of a Dinosaur - January 18, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
A New Doctor
In the sixth long year after college graduation, at long, long last, the NinjaBaker has achieved the pinnacle of academics. And I am no longer the only doctor in the family:
With the awarding of his PhD in Molecular Virology and Microbiology from Baylor College of Medicine in Houston, my little Nestling-turned-NinjaBaker has earned the new blog-moniker of Dr. Ninja. Needless to say, I’m bursting with pride. (Source: Musings of a Dinosaur)
Source: Musings of a Dinosaur - January 13, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Hannukah Blast
It’s been a busy year, in both good ways and bad. Long time readers (sorry, you two) may have noted the decreased blogging frequency. Apologies. I would say, “I’ll try to do better in the new year,” which I will; but no promises.
It was a very good year from the standpoint of menorah acquisitions, although procrastination reared its ugly head. So it’s only today, the last night of Hannukah, that I’ve finally gotten around to photgraphing and uploading. The result will have to be this photo-laden post, instead of having to wait all week long.
In no particular order:
I found this colorful ...
Source: Musings of a Dinosaur - December 31, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Source Type: blogs
Heard in the Exam Room
Still here, despite the slow blogging. Today’s offering is on the lighter side.
True stories:
90-year-old lady playing with her 6-year-old greatgrandson.
Kid (rolling around on the floor): Greatgrandmom, can you do this?
GGM: Oh no, honey, I can’t do that.
Kid (doing a somersault): Can you do this?
GGM: No, dear, I can’t do that.
Kid (jumping up and down): How about this?
GGM: Nope. Sorry.
Kid: Gee Greatgrandmom, can’t you do anything?
GGM: (thinks for a second) [flips her dentures out of her mouth, then slips them back in again] How about that! Can you do that?
Kid: [shocked silence]
************...
Source: Musings of a Dinosaur - December 13, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
